Candy P C
University of Ballarat, PO Box 663, Ballarat, Victoria, Australia 3353.
J Contin Educ Health Prof. 2000 Fall;20(4):228-37. doi: 10.1002/chp.1340200406.
The practice of medicine has been transformed by the convergence of a number of trends and developments. These include changes in the regulatory environment, scientific advances, the emergence of pressures for evidence-based medicine, advances in pharmaceutical knowledge and manufacture, and a shift in the nature of the patient/provider relationship. Many of these circumstances have been brought about or amplified by a variety of technological innovations. Collectively, these changes necessitate continuing--perhaps even continuous--learning and adaptation on the part of both new and established practitioners. At the heart of this need is the explosion of information and of information technologies, which shows little sign of abating. However, it is not simply the volume of information nor even its form that poses a challenge. It is also that outdated, incorrect, or unproven information is as accessible as correct, defensible, and reliable information. Therefore, doctors must be equipped not only with the ability to locate information but to evaluate its relevance and credibility. In short, they must be "information literate." Since both information and the technologies that give access to it are constantly expanding, a practitioner can never claim to be "information literate" in any absolute or final sense. It is a constantly evolving attribute and, alongside biomedical, clinical, pharmaceutical, legislative, and other domains, needs to form part of the provision of continuing education. Five propositions are advanced concerning this particular aspect of continuing medical education, and the article concludes by arguing that, in the same way that educating patients is the best defense against accidental overdose in the pharmaceutical sense, the best way to prevent "information overdose" is the education of practitioners.
医学实践已经因多种趋势和发展的融合而发生了变革。这些包括监管环境的变化、科学进步、循证医学压力的出现、药学知识与制造的进步以及医患关系性质的转变。其中许多情况是由各种技术创新引发或加剧的。总体而言，这些变化使得新老从业者都有必要持续（甚至可能是不断地）学习和适应。这种需求的核心是信息和信息技术的爆炸式增长，而且几乎没有减弱的迹象。然而，构成挑战的不仅仅是信息的数量，甚至也不是其形式。同样存在的问题是，过时、错误或未经证实的信息与正确、合理且可靠的信息一样容易获取。因此，医生不仅必须具备查找信息的能力，还必须能够评估其相关性和可信度。简而言之，他们必须具备“信息素养”。由于信息以及获取信息的技术都在不断扩展，从业者永远不能宣称自己在任何绝对或最终意义上具备“信息素养”。这是一个不断演变的属性，并且与生物医学、临床、药学、立法及其他领域一样，需要成为继续教育的一部分。本文提出了关于继续医学教育这一特定方面的五个命题，文章最后指出，就像教育患者是防止药物意外过量的最佳防御措施一样，防止“信息过量”的最佳方法是对从业者进行教育。
